Position Statement: Cardiopulmonary Resuscitation of Patients with Confirmed or Suspected COVID-19 - 2020

Hélio Penna Guimarães1, Sérgio Timerman2, Roseny Dos Reis Rodrigues1

  • 1Hospital Israelita Albert Einstein, São Paulo, SP, Brasil.

Insights

During the COVID-19 pandemic, cardiac arrest care requires specific protocols. Recommendations emphasize aerosol precautions, early airway management, and HEPA filters for patient and staff safety.

Area of Science:

  • Emergency Medicine
  • Cardiology
  • Critical Care
  • Anesthesiology

Background:

  • COVID-19 pandemic presents unique challenges for cardiac arrest management.
  • Limited robust evidence necessitates updated guidelines for healthcare workers.
  • Protecting both healthcare professionals and patients is paramount during resuscitation efforts.

Purpose of the Study:

  • To provide joint recommendations for cardiac arrest care during the COVID-19 pandemic.
  • To guide healthcare workers in implementing safety measures and specific interventions.
  • To address unique aspects of cardiac arrest in COVID-19 patients, balancing standard protocols with pandemic-specific needs.

Main Methods:

  • Development of a joint position statement by leading Brazilian medical societies.
  • Inclusion of recommendations for personal protective equipment and aerosol precautions.
  • Emphasis on addressing specific cardiac arrest causes relevant to COVID-19, such as hypoxia and myocarditis.

Main Results:

  • Mandatory use of full aerosol precautions, including appropriate personal protective equipment.
  • Recommendations for early invasive airway device placement and HEPA filter use.
  • Specific guidance on ventilator settings and rescuer positioning for cardiac arrest during mechanical ventilation or prone positioning.

Conclusions:

  • Adherence to aerosol precautions and HEPA filter use is critical during cardiac arrest resuscitation in the COVID-19 era.
  • Early recognition and management of COVID-19-specific cardiac arrest etiologies are essential.
  • Modified resuscitation techniques may be required, while otherwise adhering to established national and international guidelines.

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